冠状动脉再通临床标准与造影结果的对比研究

A Comparative Study of the Clinical Criteria of Coronary Reperfusion after Thrombolytic Therapy and the Result of Coronary Angiography

目的 :探讨 1996年《中华心血管病杂志》编委会推荐的“急性心肌梗死溶栓疗法参考方案”中关于溶栓治疗后冠状动脉(冠脉 )再通的临床标准的准确性。方法 :对 82例急性心肌梗死患者在静脉溶栓治疗后 5～ 7d行冠脉造影 ,以造影结果为标准 ,达TIMI分级标准Ⅱ级以上为再通 ,分析参考方案中两项、三项指标的不同组合及四项指标与血管再通与否的关系。结果 :以参考方案所推荐的临床标准判断冠脉再通 5 6例 ,未通 2 6例 ;以冠脉造影结果判断冠脉再通 5 8例 ,未通 2 4例。临床标准的敏感性 86 .2 % ,特异性 75 % ,准确性 82 .9%。结论 :参考方案所推荐的临床标准能比较准确地判断急性心肌梗死溶栓治疗后冠脉是否再通。

Objective: To evaluate the accuracy of the clinical criteria to predict reperfusion status after thrombolysis in acute myocardial infarction (AMI) suggested by Chinese Journal of Cardiology in 1996. Methods: Coronary angioraphy was performed in 82 cases of AMI after five to seven days of thrombodysis therapy. We regarded the TIMI Ⅱand over it in coronary angiography as coronary reperfusion and compared the relationship between clinical criteria and coronary angiogram to perdict reperfusion status after thrombolysis in AMI. Results: Clinical criterion of coronary reperfusion after thrombolytic therapy showed 56 cases of reperfusion and 26 cases of non-reperfusion, while coronary angiography showed 58 cases with reperfusion and 24 cases with non-reperfusion. The sensitivity, specificity and accuracy of the clinical criteria in prediction of coronary patency were 86.2%?75% and 82.9% respectively. Conclusion: The clinical criteria to predict reperfusion status after the thombodysis in AMI suggested by Chinese Journal of Cardiology in 1996 is excellent, it can precisely predict coronary reperfusion after the thrombodysis in AMI.